Pathological gambling is conceptualized as an addictive disorder on the grounds that it exhibits many phenomenological similarities to substance-abuse disorders.

Higher rates of alcoholism and other substance use have been reported among gamblers than in the general population. Rates of lifetime substance use among pathological gamblers from the community and from treatment settings range from 25% to 63%. Likewise, rates of pathological gambling appear to be higher among substance-abusing populations than the general population.

Alcohol and drugs may be used by the gambler as a way of coping with the guilt and depression following a big loss, or an alcohol/drug user may use gambling as a means of trying to win money to buy alcohol and drugs.

An examination of the role of gender shows that male alcohol and cocaine subjects are more likely to report gambling problems in the past year. Risk for developing a gambling problem seems to be linked with gender for some drug classes (i.e., alcohol, cocaine) but not others (i.e., cannabis and opiates). A greater proportion of men who have a positive history for psychiatric diagnosis have gambling problems than do females.

A number of descriptive surveys of adolescent gambling show strong correlations between gambling, alcohol, and other substance abuse as well as delinquency.

Research in comorbid alcohol dependent and pathological gambling populations indicates that the presence of more than one impulse control disorder or substance abuse disorder results in more severe decision making and self-control deficits.